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INDIANA SALES DISCLOSURE FORM SDF ID: 1iA'� Paee 2
Ray M. Druley Attorney No. 4759 -26
Plepara'Afthe Sales DlMSosu c Farm nde
505 N. Church St., P.O. Box 146 Law Office of Ray M. Druley
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Address (Number andSovet) Company
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Fort Branch, IN 47648
Clry. Smcc and ZIP Code Telephone Number E -mail
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Sellerl•Name as a Pis conveyancrd ment
Sefler2 -Name as appears on conveyance document
inn aQI-�' h cep +er S-i reef -
Addrm(Numbrr and Street)
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Address (Number and Street)
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city Senn- and ZIP Cod,
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E -mail
Telephone Number E -mall
Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to the best of my knowledge and belief, Is true, correct
and c mplete a required b law, an is prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act".
Sig (urea Bel Signoture of Seller
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PrmwName Seger U Sin Diffe fsUu PlinadMant, Seller 51 nDOte MM/OD
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Buyer] -Nome us appears on conveyance document
Buyer 2 - Name as appears on conveyance document
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Addrrss(NUmber and Streeq
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Address (Number and Sneer)
OtY.Sm�t7gand ZIPCodr�
City. Smu, and ZIP Cade
E -mail
Telephone Number E -mail
PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
fHE SALES DISCLOSURE FORM MAYBE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS
YES NO CONDmON
YES e NO CONDITION
❑ 1. Will this property be the buyer's primary
❑ 3. Homestead -
residence? Provide complete address of primary
❑ C�( 4, Solar Energy Heating /Cooling System
residence, including county:
❑ 5. Wind Power Device
❑ [� 6. Hydroelectric Power Device
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❑ (� Geothermal Energy Heating /Cooling Device
Cysmtr
ZIP de county
❑ 2. Does the buyer have a homestead to be vacated for
❑ 8. is this property a residential rental property?
this residence? If yes, provide complete address of
residence vacating, including county:
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Addrma(NumbrrandSM , t)
City, Swa ZIP Code County
Under penalties of perjury, l hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and com lete as required law, a prepared In accordance with IC 6- 1.1.5.5, "Real Property Sales Disclosure Act".
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Printed Nona if Buyer I Sian Dvtr MM D Prinmd N ... f Buyer g Sion DOW MM/DD
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